VULSELLUM FORCEP: Single toothed (bullet

 VULSELLUM FORCEP:

1. Single toothed (bullet forceps) Tenaculum
2. Double toothed (Fenton’s bull-dog vulsellum or the lion’s forceps)
3. Multiple toothed vulsellum (Tenaculum)

      INDICATIONS:

1. Grasping of the cervix
   1. During minor office practice manipulations, e.g. insersion os a uterine sound, or an IUCD in difficult cases and during insufflation and hysterosalpingography.
   2. To estimate the degree of uterine descent in cases of prolapse by pulling on the cervix downwards and observing the level to which it reaches
   3. To evaluate the mobility of the uterus; this may be limited in fibroid tumors.
   4. During vaginal operations, e.g. dilatation and curettage and repair of prolapse.
   5. To help correction of RVF by pulling backwards on the anterior lip of the crvix.
2. To grasp a prolapsed submucous myoma during a vaginal myomectomy.
3. During operation of hysterectomy it can be used to hold the cercal stump after the removal of the uterine body in subtotal hysterectomy.

       CONTRAINDICATIONS:

• The soft pregnant cervix,
• Infections,
• Suspicious malignancy of the cervix.

    COMPLICATIONS:

1. Lacerations of the cervix.
2. Infections
3. Bleeding from the site of the bite of the teeth of the vulsellum